NEW DELHI: A leading Indian-origin cardiologist in the UK has cautioned, poor diet is a major cause behind the COVID-19 deaths and the Indians must urgently cut down on ultra-processed food to build resilience against the deadly virus.

Obesity and excess weight was the “elephant in the room” that needs to be addressed as a major factor behind the deaths from the coronavirus, Said, Dr Aseem Malhotra, who is among the UK’s National Health Service frontline medics and also a professor of evidence-based medicine.

The 42-year-old medic, who is on a mission to spread awareness around lifestyle changes as a major weapon in the fight against coronavirus, Says, “India is particularly vulnerable, having a very high prevalence of lifestyle-related diseases.”

He noted, “Specifically, conditions such as Type 2 diabetes, high blood pressure, heart disease are three of the major risk factors for death from COVID-19. This is rooted in excess body fat, a cluster of conditions known as metabolic syndrome.”

Western countries such as the US and the UK have seen some of the highest death rates from COVID-19 in the world, which are likely to correlate with unhealthy lifestyles.

He pointed out, “The elephant in the room is that the baseline general health in many Western populations was already in a horrendous state, to begin with. In the UK and US, more than 60 per cent of adults are overweight or obese.”

In the US, less than one in eight people are metabolically healthy, which means having normal blood pressure, having a weight circumference if you are a man less than a 102cm and less than 88cm for a woman and healthy levels of blood sugar and good cholesterol.

Malhotra, who is from New Delhi, says, “There’s no such thing as a healthy weight, only a healthy person. If people try to maintain all these metabolic health parameters through a healthy lifestyle, this could potentially be achieved within a few weeks of just a change of diet.”

A recent report in the ”Nature” science journal revealed that patients with Type 2 diabetes and metabolic syndrome might have up to 10 times greater risk of death when they contract COVID-19 and called for mandatory glucose and metabolic control of Type 2 diabetes patients to improve outcomes.

Malhotra warns that the medications that are used for Type 2 diabetes and many of the other conditions have “very, very marginal effects” in terms of improving lifespan or reducing the risk of death, which most people are not made aware of, and they also come with side effects.

Also, He said, “This is not to say that medications should be discontinued but the lifestyle changes are considerably more impactful on health and will reduce the need for medication. The positive news is that you can reverse this, but it is not being made aware to patients or practised by the majority of physicians as lifestyle prescriptions in India.”

Based on his own clinical experience and also reflected across medical literature, the expert recommends giving up ultra-processed foods, which covers any packaged food that comes with five or more ingredients, because usually, these are high in sugar, starch, unhealthy oils, additives and preservatives.

In the UK, these foods now represent more than 50 per cent of the diet, which he says is “really quite staggering and shocking”.

Similar figures are there for the US and probably to some degree reflect why there is specifically more increased death rates from COVID-19 in these countries.

“So, what I would advise the Indian population is to completely cut out these types of food from their diet, make sure that you are cooking from scratch, do not snack,” the doctor said.

“Beyond that, the other issue in Indian diet is that we have a very high intake of refined carbohydrate foods, these are also foods that are particularly harmful in excess because they raise glucose and insulin and therefore rooted in many of these chronic conditions such as Type 2 diabetes, high blood pressure and heart disease – this involves too much consumption of flour and white rice.

“These must be swapped with a variety of whole foods such as vegetables and fruits and for those who are non-vegetarians, it is completely fine to eat red meat as well as full-fat dairy products, eggs, fish etc,” he said.

In reference to recent data on the higher risk faced by black, Asian and minority ethnic communities in the UK from coronavirus, the NHS doctor believes that disparity is also cultural or lifestyle-related.

He said, “South Asians have been found vulnerable because the prevalence of the metabolic syndrome is three-four-fold higher in the population. Indians, therefore, I think have to be extra careful with their diet and what they are consuming and they should also not have the illusion of protection just because they are given a normal body mass index (BMI). Extra body fat, particularly around the waist, is much more detrimental to health than using outdated indices such as BMI to define health risk.”

A major British clinical trial has found hydroxychloroquine has “no benefit” for patients hospitalized with COVID-19, scientists said Friday, in the first large-scale study to provide results for a drug at the center of political and scientific controversy.

Hydroxychloroquine, a decades-old malaria and rheumatoid arthritis drug, has been touted as a possible treatment for the new coronavirus by high profile figures, including US President Donald Trump, and has been included in several randomized clinical trials.

The University of Oxford’s Recovery trial, the biggest of these so far to come forward with findings, said that it would now stop recruiting patients to be given hydroxychloroquine “with immediate effect”.

“Our conclusion is that this treatment does not reduce the risk of dying from COVID among hospital patients and that clearly has a significant importance for the way patients are treated, not only in the UK, but all around the world,” said Martin Landray, an Oxford professor of medicine and epidemiology who co-leads the study.

The randomized clinical trial—considered the gold standard for clinical investigation—has recruited a total of 11,000 patients from 175 hospitals in the UK to test a range of potential treatments.

Other drugs continuing to be tested include: the combination of HIV antivirals Lopinavir and Ritonavir; a low dose of the steroid Dexamethasone, typically used to reduce inflammation; antibiotic Azithromycin; and the anti inflammatory drug Tocilizumab.

Researchers are also testing convalescent plasma from the blood of people who have recovered from COVID-19, which contains antibodies to fight the virus.

Researchers said 1,542 patients were randomly assigned to hydroxychloroquine and compared with 3,132 patients given standard hospital care alone.

They found “no significant difference” in mortality after 28 days between the two groups, and no evidence that treatment with the drug shortens the amount of time spent in hospital.

“This is a really important result, at last providing unequivocal evidence that hydroxychloroquine is of no value in treatment of patients hospitalized with COVID-19,” said Peter Openshaw, a professor at Imperial College London, in reaction to the results.

He added that the drug was “quite toxic” so halting the trials would be of benefit to patients.

Hydroxychloroquine has been in use for years but it has a number of potentially serious side effects, including heart arrhythmia.

Researchers from the Recovery trial said they would share their data with the World Health Organization (WHO), which on Wednesday restarted its own trials of hydroxychloroquine.

They were temporarily halted last month because of a now-retracted observational study in The Lancet medical journal that had suggested hydroxychloroquine and chloroquine, a related compound, were ineffective against COVID-19 and even increased the risk of death.

Authors of The Lancet research said on Thursday that they could no longer vouch for the integrity of its underlying data, in the face of serious concerns raised by fellow scientists over a lack of clarity about the countries and hospitals that contributed patient information.

The scandal cast a shadow over The Lancet and another top medical journal, but it did nothing to clear up the increasingly politicized question of whether or not hydroxychloroquine works as a treatment for COVID-19.

Openshaw said the Recovery trial should be credited with continuing the research until they could reach a definitive conclusion on hydroxychloroquine.

“Everyone regrets that it doesn’t work, but knowing that allows us to focus on finding drugs that actually help recovery from COVID-19,” he added.

Oxford professor Peter Horby, the lead investigator on the Recovery Trial, said there was probably a “very large number” of people around the world taking hydroxychloroquine for COVID-19, with countries including the US, China and Brazil authorizing it.

A separate clinical trial on Wednesday in the US and Canada found that taking hydroxychloroquine shortly after being exposed to COVID-19 does not work to prevent infection significantly better than a placebo.

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